- 1 What is meant by infertility?
- 1.1 Why has infertility increased within the young generations?
- 1.2 What happens in fertilization?
- 1.3 Tips for a healthy conceiving
- 1.4 Are there any treatments that enhance fertility?
- 1.5 Infertility in men
What is meant by infertility?
Infertility is the inability for conceiving due to a failure of the reproductive system after 12 months or more of regular sexual intercourse without using contraceptive methods. The failure can be with either the male partner or with the female partner.
There are two types of infertility.
- When a couple cannot conceive at least once after 1 year of having unprotected regular sexual intercourse. This is primary infertility.
- When a couple has gotten pregnant once, but unable to conceive after that. This is secondary infertility.
Why has infertility increased within the young generations?
Infertility has become a major threat for many countries in the 21st century. According to the statistics, the number of births per year in most of the countries such as China, the UK, USA has shown a dramatic decline within the past few years.
The world is moving into a technological era. And crop cultivation, food manufacturing, medical inventions, drug usage, and everything develops with the technology. As most of these chores are done by types of machinery, their efficiency has increased than proceeding manually.
Is this development beneficial for humans? Yes, it makes our lives easier. Then why do non-communicable diseases such as diabetes and high blood pressure rising? Why are there so many couples with infertility?
Back in the day most of the families had 10-20 children in their families. But nowadays the number of children has decreased up to 1-2 in most families. What is the reason behind this?
This dramatic decrease in births has been occurred due to many reasons.
- Competitive and stressful lifestyle
- Age of the woman (the older the more infertile)
- Disorders within either of the couple (ovulation disorders, spermatogenic disorders, etc.)
- Higher usage of contraception
- The poor economic status of families
- Increase of homosexuality (lesbian and gay couples)
- Genetically modified crops used in food and beverage manufacturing
- Usage of harmful medications and drugs
- Smoking and high consumption of liquor
- Uncontrolled body weight and hormonal imbalances
- Exposure to harmful radiations (with increased usage of mobile phones and other devices)
What happens in fertilization?
To conceive a fetus, the fertilization of an egg with a sperm should take place. During sexual intercourse, the sperms are entered into the female reproductive tract and they reach the egg. The ovulation of females occurs by the ova. Then the egg moves down to the uterus through the fallopian tubules.
If the sexual intercourse happens during the time where the egg is in the ampulla region of the fallopian tubule, it’s in the ideal condition to fertilize. If a sperm reaches the egg in this stage it penetrates the egg. When the two nuclei of the sperm and the egg bind together it forms an embryo. This embryo is moved into the uterus slowly and implants on the endometrium. Consuming the nutrients through blood vessels in the endometrium it grows up to a full-sized fetus. At this stage, you can identify that you are conceived with a baby.
Tips for a healthy conceiving
- Control of body weight- this is the most important factor in pregnancy. Obesity can cause certain hormonal imbalances within the body. And also doing strenuous exercises would neither be effective. Because exercises reduce the body fat amount excessively it can cause underweight and again it’s not effective. Therefore, try to manage moderate body weight by getting healthy balanced diets with regular exercises.
- Age- a girl’s age is an important factor when it comes to fertility. The ideal age limit is recommended for pregnancy is between 18-35. Ages below 18 or above 35 can be a bit challenging because they have a high risk of teratogenicity and miscarriage.
- Health habits- prevention from smoking, liquor, and abusive drugs can be a blessing when considering fertility. All of these activities are related to suppressing the nervous system. This can eventually drop your sexual libido and fertility. Drug-addicted mothers give birth to drug-addicted babies if they survive pregnancy after continuous usage of drugs. These types of cases are reported from the US. This can be harmful to the baby.
- Food- the meal you get is important to build up your immunity as well as fertility. Some food improves fertility.
- Sunflower seeds
- Berries (raspberries, blueberries)
- Citrus fruits
- Full-fat dairy products
- Meat liver
- Egg yolks
- Greek yogurt
- Salmon fish
- Egg yolks
What are the symptoms of conceiving?
There are some instances that women can notice that they have fertilized. You can feel that you are fertilized by the symptoms you get from implantation. In the early stages of implantation, some women can feel,
- cramps in the lower abdomen
- light bleeding, nausea
- soreness of the breast
- mood swings
- changes in the basal body temperature.
How long does it take to feel the signs of fertilization?
5 or 6 days after having sexual intercourse, these symptoms might occur. This can be changed from woman to woman. Implantation takes place usually after 6 to 12 days of fertilization. If you need more clarification,
- 10-14 days after your periods- ovulation takes place
- 2-5 days after ovulation- fertilization can take place if you have sexual intercourse
- 6-12 days after fertilization- implantation can take place.
Are there any treatments that enhance fertility?
When married couples notice that they don’t get pregnant while trying to conceive for about 12 months, they head to a gynecologist and get the necessary treatments. Infertility is common among many modern couples. And for the treatments, there are many methods other than drugs.
- Educating the couple
- Testing the cause of infertility in both male and female
- Prescribing necessary medications
- Stepping into modern solutions such as IVF
After the physical checkups, if there is no physical issue, the gynecologists prescribe the necessary medications. These can be different for males and females.
>To induce ovulation in the female–
- Clomiphene or comid tablets increase the synthesis of FSH (follicle-stimulating hormone) by the pituitary gland. FSH induces the ovulation and growth of the egg.
- Gonadotropin injections such as Menopur, Gonal F are given in 75IU daily dose.
>To induce male fertility-
- Clomiphene or comid tablets stimulate the production of testosterone hormone needed for the synthesis and growth of healthy sperms.
- Anastrozole or Arimidex drug is given commonly to improve the libido and erectile function of the penis.
- Human chorionic gonadotropin (hCG) is given in the lower testosterone males. This hormone acts similar to testosterone and stimulates the production and growth of sperms.
What if the couple fails to conceive even after medications?
Well, medicines are not the only solution for this. The improvement of modern technology would help you in this case. There is a variety of assisted reproductive technology (ART) used in the present. The most commonly used technology is In Vitro Fertilization (IVF).
The medical meaning of IVF is the conception of a baby using a complex series of procedures used to prevent genetic problems and to overcome infertility issues, by fertilizing a collected mature egg with sperms inside a laboratory.
There are specialized IVF doctors to consult this procedure. And in some countries, there are special clinics and IVF hospitals that do these IVF in the laboratories.
What happens after fertilization in IVF?
The formed embryo is inserted into the mother’s uterus endometrium for further growth. But if there is a rejection of any other problem within the mother’s uterus, the fertilized embryo is inserted into another healthy woman. These women who rent their wombs are called surrogate mothers.
Renting a womb is expensive but safer because the renter is usually trusted for her healthy deliveries in history. However, continuous monitoring is done.
Infertility in women
When someone says “the girl is fertile” this means the girl is capable of or healthy enough for conceiving a baby. Female fertility is a major factor affecting the annual birth rate of a country.
Infertility in women is caused by several reasons.
- Hormonal imbalance which prevents the proper ovulation (thyroid and pituitary hormonal problems)
- Abnormal menstrual cycle
- Age (the older the more infertile)
- Obesity or overweight
- Extreme exercises and low body fat content
- Problems with the uterus (polyps, fibroids, septum, or adhesions inside the uterus)
- Issues with the fallopian tubules (the commonly pelvic inflammatory disease caused by chlamydia and gonorrhea can affect)
- Abnormalities in the number of eggs and the quality of eggs produced by ovaries
- Autoimmune disorders (Lupus, rheumatoid arthritis, Hashimoto’s disease, Thyroid dysfunction)
- STDs (sexually transmitted diseases)
- Polycystic ovary syndrome (pos)
- High alcohol consumption or excessive consumption of any substance
- Primary ovary insufficiency (POI)
- Tumors in any organ of the reproductive system
- History of ectopic pregnancies and related surgeries (implantation in the fallopian tube)
- DES syndrome (caused by a medication given to prevent premature birth and miscarriage)
What are the female infertility symptoms?
When looking into the above-mentioned factors, we can see that getting pregnant with a baby is indeed miraculous. You, me, any woman can be infertile for one of the above reasons. How can you identify if you are infertile?
- Pain during sex
- Darker menstrual blood
- Abnormal menstrual cycles
- Heavy, long menstruation
- Hormonal changes
- Obesity or sudden unexplainable weight gain
- Not getting pregnant after 12 months of unprotected sexual intercourse
- Chronic pelvic pain
- back pain
- pain with bowel movement and uncomfortable defecation
- sudden, extreme acne
- significant hair growth
How can I diagnose my infertility?
If you doubt that you have got the above symptoms you can consult a gynecologist about it. There are many tests that you can do to clarify if you are infertile or fertile.
- Blood tests can be done to test your blood progesterone levels. As estrogen plays an important role in female fertility, this test is very commonly done. Sometimes other hormones such as progesterone, hCG, FSH are also tested. The glands such as the hypothalamus, pituitary, and ovaries play a major role in female reproduction. An abnormally low concentration of any of those hormones can cause female infertility.
- A chlamydia test is done to examine the cells in your cervix. A urine test will be an alternative to this test because the cells can be present in the urine too. Chlamydia infection is known to cause infertility in women. Most of the time necessary medications are given to cure this infection.
- Ultrasound scanning is done to check the condition of your womb, ovaries, and fallopian tubules. Abnormal conditions such as endometriosis, fibroids, and many other physically observable disorders can be identified through this.
- An X-ray scanning test is done to diagnose blockages within your reproductive tract. Hysterosalpingogram is an X-ray of your womb and fallopian tubules, done by injecting a spot of ink into the tract.
- Laparoscopy is done by inserting a small camera into the reproductive organs such as ovaries, fallopian tubules, and uterus by cutting the lower abdomen. If you had a history of pelvic inflammatory disease, this scanning is prescribed.
What are fertility drugs for women?
For the fertility of women, the main factor is ovulation. The healthier and regular the ovulation, the more fertile the woman. So to improve ovulation there are a variety of drugs and medications prescribed by gynecologists.
- Clomiphene citrate is prescribed for women who are diagnosed with having normal levels of pituitary hormones but showing no changes monthly.
- Aromatase inhibitors are prescribed for women with polycystic ovary syndrome.
- Insulin sensitizing agents such as metformin are prescribed for women with polycystic ovary syndrome and also having diabetes
- Gonadotropins are given to regulate pituitary hormones and egg growth.
Infertility in men
Not only women, but men can also be infertile. There are many factors that they can be infertile with. Following are the major reasons for male infertility.
- Low production of sperms by the testicles
- Low sperm count per 1ml of semen (the normal count is 15 million – 200 million of sperms in 1ml of semen ejaculate)
- Abnormal sperm shapes and sizes (Ex: – giant sperms, micro sperms, double-headed sperms, double body sperms, long-headed sperms, rough headed sperms, abnormal necked sperms, defected tail sperms)
- The inability of the movement of the sperms (low motility)
Behind these reasons, there are many causes of infertility in men.
What are the reasons behind male infertility?
- Undescended testicles
- Genetical defects
- Gonorrhea Formation of abnormal sperms
- Varicocele in testicles
- Blockage of testicles
- Premature ejaculation
- Cystic fibrosis
- Damage to the reproductive organs
- Exposure to harmful environmental factors such as chemicals and radiation
- Smoking and alcohol
- Tumors in the reproductive system
What are the signs of infertility in men?
Infertility can be identified in the first stage if you pay attention to the physical changes. If you are having unprotected sexual intercourse for 12 months and still your female partner doesn’t get pregnant, it is a sign of either of your infertility. In most cases, low sperm count is identified as a reason for infertility. Among the symptoms of infertility in men,
- Low libido
- Sexual dysfunction
- Pain in the genital area
- Swelling of testicles
- Continuous respiratory infections
- Inability to smell
- Gynecomastia (growth of breast)
- Decreased beard growth and hair growth are drawn to the attention.
Tests conducted for male infertility
Infertility can be tested physically, as well as by testing semen. In general, most of these tests are called “sperm tests”. But there are many tests to clarify which part of the process has the failure. If you have noticed the above symptoms within you, make sure to consult a male reproductive doctor and get the necessary tests done.
- The first thing to do will be a physical examination. Here your genital areas can be examined by the doctor and a few information about your sexual habits since adolescence, chronic diseases, surgeries, and illnesses will be taken.
- Testing semen– you can collect a sample of semen by masturbating and collecting the semen into a container. Or you can have sexual intercourse and collect the semen using a condom. In this test, they check the number of sperms per 1ml of the semen sample.
- Scrotal ultrasound scanning– by this scanning, the varicose conditions in the testicles or other sexual organs can be identified.
- Transrectal ultrasound scanning– in this test a lubricant swab is entered into the rectum. This helps the doctor to get an idea about your prostate gland functions and to identify whether there are blockages in the seminiferous tubules and other tracts of the male reproductive system.
- Testing blood hormone levels– in a male reproductive system, the main glands that are involved are, hypothalamus, pituitary gland, and testicles. Abnormalities in hormone production by these glands may affect the sexuality of a male. The hormone testosterone is in the main role. And it’s concentration in the blood is also checked in these cases.
- Post-ejaculatory urine analysis– in this test, you can test whether your sperms have traveled backward into the bladder without moving out of the body during ejaculation.
- Genetic testing– here, congenital disorders such as chromosomal defects are tested. Usually, the defects in the Y chromosome create problems in male fertility.
- Testicle biopsy– this is done by collecting the samples of sperms from testicles. If the sperm concentration seems normal in testicles, the problem can be most probably with a blockage of the tubules.
- Sperm motility testing– these tests are done to clarify whether the sperms are reaching the egg, and penetrating the egg.
What are the treatments for male infertility?
There are many physical treatments as well as medications to improve male fertility. When a couple isn’t conceiving for a long time both the partners are checked. When treating, doctors try to figure out which process is failed in the sexual course.
If the defect is noticed in the male there are several treatments that doctors proceed to improve fertility.
Treatments for male fertility are,
- Counseling – in reproductive failures, the first thing to do in counseling. Usually to have an active, fertile sexual life the mentality has to be free and happy. Lack of stress improves sexual libido. So the counseling is done before any treatments to see whether the couple is improving with the process.
- Assisted reproductive technologies (ART) – same as for women, In Vitro fertilization can be done by collecting the sperms from the male and healthy egg from the female.
- Hormonal treatments (administration of steroid hormone supplements)- this can improve the maturation of sexual organs as well as it can improve spermatogenesis. Giving testosterone or HCG treatments can improve the male libido and sexual activeness.
- Treatments for infections in the reproductive tract. (antibiotics are prescribed)- sometimes reproductive tract infections can cause sexual dysfunction in men. The necessary antibiotics can improve fertility by destroying the microbes and recovering sperm generation.
- Surgeries related to varicose and vasectomy reversals– vasectomy surgery is done as a permanent birth control method for males. This is reversible. Varicose in the testicles is also reversible by surgery.
- Medications for healthy sperm growth and ejaculation- some medicines such as vitamin D, Ashwagandha, antioxidants, folic acid, zinc, etc. are proven for the increase of male fertility.
- Intake of Fenugreeks- fenugreek supplements are known for their improvement in spermatogenic induction.
- Regular exercises and prevention of obesity– regular exercises can maintain sperm growth in a good condition.
- Getting healthy diets– some food can induce infertility as well as some food induce fertility. You should have an idea about your daily meals in this case. For example, soybean products are known for their action of infertility in males. Some estrogen-rich food is also not recommended for males.
- good sleep and resting– this helps the mental relaxation which is the most important factor in sexual reproduction
- preventing from smoking and alcohol– the tobacco in smoking have caused infertility in a lot of studies. And also alcohol addiction is a key reason for male infertility and decreased sperm count.
- Avoiding harmful medicines and drugs– there some medications that drop your fertility. Anti-androgens, opiates, anti-inflammatory drugs, some antibiotics, methadone, antidepressants, antipsychotics can cause infertility in males.